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Beyond Biomechanics: Stepping Away from Structuralism to Sensible Training and Tolerance with Endurance Athletes · MSKMag OutLoud

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  Beyond Biomechanics Stepping away from structuralism to
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  sensible training and
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  tolerance with endurance athletes Written by Mike James
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  Therapists treating
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  SPEAKER_00: runners,
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  cyclists or triathletes can often feel frustrated when athletes
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  keep breaking down
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  SPEAKER_00: despite everyone's best efforts.
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  I now work exclusively with endurance athletes and have spent
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  recent years helping
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  SPEAKER_00: therapists understand how these people tick and how we can help them more
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  SPEAKER_00: effectively.
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  For decades we were trained to think in terms of structure and
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  mechanics.
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  SPEAKER_00: Weak glutes, flat feet, overpronation, knee valgus, tight calves.
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  SPEAKER_00: The logic was simple.
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  SPEAKER_00: Find the fault, fix it, prevent injury, boost performance.
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  SPEAKER_00: But if you've noticed that fixing the fault doesn't always stop injuries,
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  SPEAKER_00: you're discovering a bigger truth.
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  SPEAKER_00: Endurance athletes rarely get injured because one
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  SPEAKER_00: or many mechanical flaws.
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  More often,
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  tissues simply weren't ready for the training and competition
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  load demanded of them.
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  SPEAKER_00: Biomechanics is always a hot topic and sometimes worth exploring,
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  SPEAKER_00: but it's not what I see most therapists struggle with.
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  SPEAKER_00: Other than trying to direct the athlete's beliefs away from it,
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  the real sticking point is how we talk with athletes about
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  tissue and load
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  SPEAKER_00: tolerance,
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  and how to use that in rehab and or management of their ongoing
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  training and
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  SPEAKER_00: racing.
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  SPEAKER_00: Many clinicians tell me,
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  SPEAKER_00: I know biomechanics isn't the whole story anymore,
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  but I don't know how to explain load and tissue tolerance to
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  athletes or use it in
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  SPEAKER_00: rehab.
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  SPEAKER_00: This article is for you.
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  SPEAKER_00: We'll look at why biomechanics isn't enough,
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  SPEAKER_00: what tissue tolerance really means,
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  SPEAKER_00: and how to guide endurance athletes with simple,
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  SPEAKER_00: effective load-based strategies.
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  SPEAKER_00: Why the biomechanical lens falls short.
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  SPEAKER_00: I remember the late 90s and early 2000s.
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  SPEAKER_00: Weekends spent on CBD courses,
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  watching people walk across paper runways so I could hunt for
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  floors and prescribe
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  SPEAKER_00: foam padding,
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  SPEAKER_00: orthoses or elaborate corrective exercises for obscure muscles.
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  SPEAKER_00: I thought I was an expert.
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  SPEAKER_00: Sometimes patients improved, but often they didn't.
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  SPEAKER_00: As my reasoning evolved, I questioned everything.
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  SPEAKER_00: If biomechanics didn't consistently fix problems,
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  SPEAKER_00: why were some athletes improving while others weren't?
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  SPEAKER_00: Let's be clear.
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  SPEAKER_00: Biomechanics